Print out application, and return completed form to the Main Street Office

Bloomfield Main Street Paint-A-Thon Grant Application  

Matching Grant of up to $250 each 

Name of Business/Building_____________________________________________________________

Address:_______________________________________Phone Number:________________________

Age of Structure:________ Proposed date of completion__________

Use of funds requested: ____________________________________

Name of Contractor or Individual responsible for labor:_________________________________________

Other comments/documentation which are pertinent to the award of the grant: _________________________

_____________________________________________________________________________________

*Professional Design Recommendations of Iowa Main Street/Tim Reinders must be utilized.

Signature of applicant____________________________________________ Date:___________________

Office use only:

Project deemed:____Eligible_____Not Eligible for grant      Amount of Grant Awarded: $____________